Clinical presentations of schistosoma hematobium: three case reports and review

Urinary schistosomiasis is a prevalent parasitic infection in certain areas of Africa and the Middle East. It could present with common as well as unusual urological symptoms, which poses a considerable diagnostic challenge in countries where there is relative low incidence of the disease. We describe three unusual cases of urinary schistosomiasis identified in patients presenting to a London hospital. One patient was found to have schistosomiasis in the seminal vesicles following surgery for prostatic adenocarcinoma. Another was found to have schistosoma-related granulomatous inflammation within a urachal cyst. Thirdly a patient was found to have simultaneous occurrence of transitional cell carcinoma and schistosomiasis of the bladder. We review the literature on the presentations of the parasite and its association with malignancy. In conclusion, awareness of the disease prevalence, clinical and histopathological features will help to avoid missing the diagnosis.

Patient information leaflets for Transrectal Ultrasound guided prostate biopsy: Results of North Thames deanery survey

BACKGROUND

We evaluated the quality of patient information leaflets for Trans-Rectal Ultrasound guided prostate biopsies (TRUS-Bx) in North Thames region. TRUS-Bx information leaflets were requested from 24 hospitals in the region. All hospitals were contacted by telephone, and non-responders were followed-up by postal survey. Leaflets received were evaluated for a clear description of the procedure, directions to TRUS-Bx location, a clear description of the procedure, contact for queries/concerns, information about preparation prior to procedure, information about regular medication, information on how to obtain results, instructions for follow-up arrangements, analgesia used and risk of morbidity/mortality. Additionally, the leaflets were evaluated for diagrams to clarify the procedure and the anatomy, and sources of additional information, such as reference to published articles or prostate cancer patient support groups/internet websites.

FINDINGS

In summary, a total of 17 leaflets (77%) were received. Of these, the majority (94%) had a clear description of the procedure, contact for queries/concerns (82%), information about preparation prior to TRUS-Bx (71%). Directions to TRUS-Bx location (29%), and analgesia used (35%), was very poorly described, and information on obtaining results and follow-up arrangements were described in only 12 (71%) leaflets. Complications such as risks of infection, haematuria, haematospermia and rectal bleeding, were generally explained (71%-76% of leaflets), urinary retention was mentioned in only 5 (29%) leaflets and mortality in only 1 case. Descriptive diagrams of the procedure and prostate anatomy were very rarely used, and sources of additional information were limited to 1 published article and reference to 1 prostate cancer support group.

CONCLUSIONS

This study demonstrates that there is large variation in the information supplied in TRUS-Bx patient information leaflets in the North Thames region, with some leaflets lacking vital information. It is proposed that a standard patient information leaflet incorporating all the factors in the checklist should be designed, with the incorporation of a new BAUS procedure specific consent form for TRUS-Bx.